Only Elongated Chordae Tendineae is Important Entity of MVP Syndrome

Back ground Mitral valve prolapse [MVP ]is the most common valvluar abnormities . Echocardiographically MVP classified to two types, classical MVP ,more commonly occur in male after age of 40 years and usually associated with complications and non-classical MVP, usually in young female and usually benign , but commonly associated with autonomic dysfunction [MVP syndrome ]. Method 2676 patients (1985 female Vs. 691 male), their age between 12—81 year, were referred for ECHO study because of clinical suspicion of MVP, 2-D Color-Doppler ECHO study in left parasternal long axis view was done for them in addition to 12-lead ECG, patients were triage as group 1. classical MVP [define as more than 2mm displacement of mitral valve leaflet in to left atrium in addition to leaflet thickness 5mm or more] 2. Non-classical MVP [ 2 mm or more displacement with leaflet thickness less than 5mm.] 3. This group show no displacement with normal thickness of leaflet but show only elongated and fluttering chordae tendinae labeled as only elongated chordae group and group 4 which show completely normal ECHO [ labeled as non-prolapsing MVP syndrome],this group was excluded from the study. Result 283 patients [31.58%] have classical MVP [122 female vs. 151 male], 315 patients [35.1%] show non-classical MVP [236 female vs.79 male] while 298 patients [33.25%] show only elongated chordae [216 female vs. 82 male]. While 1780 patients [66.51%] have normal ECHO [ non prolapsing MVP syndrome. Mitral regurgitation [MR] occure in 203 patients of classical MVP [71.73%] (36 female vs. 167 male) while 132 patients (42%) [89 female vs.43 male] of non-classical MVP have MR and only 6 patients (2%) [5 female vs. 1 male] with only elongated chordae show MR. Conclusion Most patients with clinical suspicion of MVP have no evidence of prolapsed by ECHO study, those with ECHO finding may show either classical or non—classical MVP. Significant number of patients show only elongated chordae tendinae without prolapsed. So elonongated chordate can consider as important cause of MVP syndrome